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General NPI Number Information
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NPI Number | 1669649810
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Entity Type | Organization
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Legal Business Name | MANKAD DENTAL ASSOCIATES PC
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 1420 WALNUT STREET SUITE #518
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4004
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Country | US
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Telephone | 215-567-5949
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Fax | 215-567-1517
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Provider Business Mailing Address
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Address Line | 1420 WALNUT STREET SUITE #518
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City | PHILADELPHIA
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State | PA
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Zip | 19102-4004
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Country | US
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Telephone | 215-567-5949
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Fax | 215-567-1517
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Authorized Official
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Title or Position | SECRETARY-MANAGER
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Name | JAY VANDNA M MANKAD
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Credential |
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Telephone | 215-567-5949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DS019431L
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License Number State | PA
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